Fattorusso Valentina, Casale Alida, Raia Valeria, Mozzillo Enza, Franzese Adriana
Section of Pediatrics, Department of Translational Medical Science (DISMET), University of Naples Federico II, Naples, Italy.
Diabetes Ther. 2017 Oct;8(5):1187-1190. doi: 10.1007/s13300-017-0289-9. Epub 2017 Aug 2.
Diabetes mellitus is the most common comorbidity in cystic fibrosis (CF). Recently, more attention has been paid to early glucose metabolism derangements (GMDs). The subject of this report is a female patient, affected by CF since 3 months of age. She presented with intermittent diabetes during early childhood. At the age of 10 years, oral glucose tolerance test (OGTT) was performed and showed glucose intolerance (IGT) status; glargine insulin therapy was started. At the age of 13 years, CF-related diabetes with fasting hyperglycemia occurred, so rapid insulin at meals was added. During the following year, clinical and nutritional status improved. Stable clinical conditions were observed in the following 3 years. This is the first case of very long-term follow-up concerning a CF patient with GMDs. Our case confirms the importance of paying attention to early GMDs in very young CF patients and seems to suggest that earlier therapy could ameliorate CF natural history.
糖尿病是囊性纤维化(CF)最常见的合并症。近来,早期糖代谢紊乱(GMDs)受到了更多关注。本报告的对象是一名自3个月大起就患有CF的女性患者。她在幼儿期出现间歇性糖尿病。10岁时进行了口服葡萄糖耐量试验(OGTT),结果显示为糖耐量受损(IGT)状态,遂开始使用甘精胰岛素治疗。13岁时,出现了与CF相关的糖尿病并伴有空腹血糖升高,于是添加了餐时速效胰岛素。在接下来的一年里,临床和营养状况有所改善。在随后的3年中观察到临床状况稳定。这是首例对患有GMDs的CF患者进行超长期随访的病例。我们的病例证实了关注CF幼儿早期GMDs的重要性,并且似乎表明早期治疗可能会改善CF的自然病程。